A Caregiver’s Prior Auth Experience and What Can Be Done to Improve the Experience

I know that many doctor like to complain about clicks, but something they hate even more than clicks is prior auths (prior authorizations).  I’ve heard so many doctors complain about how much time they spend on the phone dealing with prior authorizations.  While it’s bad for doctors, many times it’s just as bad for patients.

I recently had a chance to talk with Tonia C, mother and caregiver to an amazing boy who was diagnosed with alopecia.  She shared her experience as a parent and caregiver when she bumped into the issue of prior authorizations at the pharmacy.  Her story really highlighted the challenges patients face with prior auths.

Along with Tonia, we also had Miranda Gill MSN, RN, NEA-BC, Senior Director, Provider Services & Operations at CoverMyMeds, join us for the interview to talk about why these bad experiences happen for people like Tonia and what can be done about them.  Miranda shares what’s holding back prior authorization and talks about progress towards prospective ePA (prior auth at the point of prescribing) vs retrospective ePA (after claim rejection at the pharmacy).

Thanks to Tonia C for sharing her experience with us.  It’s always so meaningful to put a face and a story with a problem and she did that so well with prior authorization.  And thank you to Miranda for sharing what doctors and healthcare organizations can do to help avoid situations like the one Tonia C had to experience with her son.

Learn more about CoverMyMeds: https://www.covermymeds.com/

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About the author

John Lynn

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.